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Anemia in CKD

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https://www.readbyqxmd.com/read/28328097/markers-of-iron-status-in-chronic-kidney-disease
#1
Adam E Gaweda
Anemia is one of the main comorbidities related to chronic kidney disease (CKD). Until the advent of erythropoiesis stimulating agents (ESA), endogenous erythropoietin deficiency has been thought to be the main culprit of anemia in CKD patients. The use of ESAs has shed new light on the physiology of CKD anemia, where iron homeostasis plays an increasingly important role. Disorders of iron homeostasis occurring in CKD turn the anemia management in those patients into a complex multifactorial therapeutic task, where ESA and Iron dose must be properly balanced to achieve the desired outcome without exposing the patients to the risk of serious adverse events...
March 22, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28328083/oral-iron-supplementation-potential-implications-for-the-gut-microbiome-and-metabolome-in-patients-with-ckd
#2
Guus A M Kortman, Dorien Reijnders, Dorine W Swinkels
Patients with chronic kidney disease (CKD) and loss of kidney function are at increased risk for morbidity and mortality. The risks of CKD are attributed to "uremia," an increased concentration of uremic retention solutes (toxins) in the plasma. Recently, a colo-renal axis became clearly apparent and uremia has been associated with an altered gut microbiome composition and metabolism. There is a high prevalence of anemia in patients with CKD, for which patients are often treated with oral or intravenous iron...
March 22, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28321324/choosing-wisely-the-canadian-society-of-nephrology-s-list-of-5-items-physicians-and-patients-should-question
#3
Emilie Chan, Brenda Hemmelgarn, Scott Klarenbach, Braden Manns, Reem Mustafa, Gihad Nesrallah, Rory McQuillan
PURPOSE OF REVIEW: The purpose of this review is to contribute to the Choosing Wisely Canada campaign and develop a list of 5 items for nephrology health care professionals and patients to re-evaluate based on evidence that they are overused or misused. SOURCES OF INFORMATION: A working group was formed from the Canadian Society of Nephrology (CSN) Clinical Practice Guidelines Committee. This working group sequentially used a multistage Delphi method, a survey of CSN members, a modified Delphi process, and a comprehensive literature review to determine 10 candidate items representing potentially ineffective care in nephrology...
2017: Canadian Journal of Kidney Health and Disease
https://www.readbyqxmd.com/read/28302753/erythropoietin-receptor-mediated-molecular-crosstalk-promotes-t-cell-immunoregulation-and-transplant-survival
#4
Carolina Purroy, Robert L Fairchild, Toshiaki Tanaka, William M Baldwin, Joaquin Manrique, Joren C Madsen, Robert B Colvin, Alessandro Alessandrini, Bruce R Blazar, Miguel Fribourg, Chiara Donadei, Umberto Maggiore, Peter S Heeger, Paolo Cravedi
Although spontaneous kidney transplant acceptance/tolerance occurs in mice and occasionally in humans, mechanisms remain unclear. Herein we test the hypothesis that EPO, a hormone predominantly produced by the adult kidney, has immunomodulating properties that are required for spontaneous kidney graft acceptance. In vitro, in a manner dependent on the EPO receptor and CD131 on antigen-presenting cells, EPO induced the secretion of active TGFβ by antigen-presenting cells, which in turn converted naïve CD4(+) T cells into functional Foxp3(+) regulatory T cells (Treg)...
March 16, 2017: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/28302014/role-of-hepcidin-25-in-chronic-kidney-disease-anemia-and-beyond
#5
Norishi Ueda, Kazuya Takasawa
Iron is an essential element for all living organisms, but produces toxic oxidants. Thus, iron homeostasis is tightly regulated in mammals. Hepcidin-25 (hepcidin) has emerged as a molecule that regulates iron metabolism. Binding of hepcidin to its receptor, ferroportin, inhibits intestinal iron absorption and iron efflux from hepatocytes and macrophages. Decreased hepcidin enhances iron absorption and efflux. Hepcidin could be predictive of iron status and the response to iron supplementation or erythropoietin-stimulating agents...
March 16, 2017: Current Medicinal Chemistry
https://www.readbyqxmd.com/read/28294976/vitamins-and-microelement-bioavailability-in-different-stages-of-chronic-kidney-disease
#6
REVIEW
Magdalena Jankowska, Bolesław Rutkowski, Alicja Dębska-Ślizień
Chronic kidney disease (CKD) predisposes one to either deficiency or toxic excess of different micronutrients. The knowledge on micronutrients-specifically water-soluble vitamins and trace elements-in CKD is very limited. Consequently, current guidelines and recommendations are mostly based on expert opinions or poor-quality evidence. Abnormalities of micronutrient resources in CKD develop for several reasons. Dietary restrictions and anorexia lead to an insufficient micronutrient intake, while diuretics use and renal replacement therapy lead to their excessive losses...
March 15, 2017: Nutrients
https://www.readbyqxmd.com/read/28290095/a-new-approach-to-the-management-of-anemia-in-ckd-patients-a-review-on-roxadustat
#7
REVIEW
Kimberly Becker, Maha Saad
This article informs the reader of the current information available on a novel therapeutic agent and new class of drug for the treatment of anemia. The data show promising results for alternative erythropoietin-stimulating agents and offers a time line of when Phase III data will be available. The information on this new drug and new drug class will change how nephrologists approach treating anemia within their patients.
March 13, 2017: Advances in Therapy
https://www.readbyqxmd.com/read/28284384/autosomal-dominant-tubulointerstitial-kidney-disease
#8
REVIEW
Anthony J Bleyer, Kendrah Kidd, Martina Živná, Stanislav Kmoch
There are 3 major forms of autosomal dominant tubulointerstitial kidney disease (ADTKD): ADTKD due to UMOD mutations, MUC1 mutations, and mutations in the REN gene encoding renin. Lack of knowledge about these conditions contributes to frequent nondiagnosis, but with even limited knowledge, nephrologists can easily obtain a diagnosis and improve patient care. There are 3 cardinal features of these disorders: (1) the conditions are inherited in an autosomal dominant manner and should be considered whenever both a parent and child suffer from kidney disease; the presence of even more affected family members provides further support...
March 2017: Advances in Chronic Kidney Disease
https://www.readbyqxmd.com/read/28263291/iron-suppresses-erythropoietin-expression-via-oxidative-stress-dependent-hypoxia-inducible-factor-2-alpha-inactivation
#9
Keisuke Oshima, Yasumasa Ikeda, Yuya Horinouchi, Hiroaki Watanabe, Hirofumi Hamano, Yoshitaka Kihira, Seiji Kishi, Yuki Izawa-Ishizawa, Licht Miyamoto, Tasuku Hirayama, Hideko Nagasawa, Keisuke Ishizawa, Koichiro Tsuchiya, Toshiaki Tamaki
Renal anemia is a major complication in chronic kidney disease (CKD). Iron supplementation, as well as erythropoiesis-stimulating agents, are widely used for treatment of renal anemia. However, excess iron causes oxidative stress via the Fenton reaction, and iron supplementation might damage remnant renal function including erythropoietin (EPO) production in CKD. EPO gene expression was suppressed in mice following direct iron treatment. Hypoxia-inducible factor-2 alpha (HIF-2α), a positive regulator of the EPO gene, was also diminished in the kidney of mice following iron treatment...
March 6, 2017: Laboratory Investigation; a Journal of Technical Methods and Pathology
https://www.readbyqxmd.com/read/28256075/the-use-of-darbepoetin-to-stimulate-erythropoiesis-in-the-treatment-of-anemia-of-chronic-kidney-disease-in-dogs
#10
E H Fiocchi, L D Cowgill, D C Brown, J E Markovich, S Tucker, M A Labato, M B Callan
BACKGROUND: Darbepoetin alfa (darbepoetin) is an erythropoiesis-stimulating agent used for the treatment of anemia secondary to chronic kidney disease (CKD) in dogs, but reports describing response are lacking. HYPOTHESIS/OBJECTIVES: To evaluate the effectiveness of darbepoetin in dogs with anemia secondary to CKD, dosing protocols, and adverse events. ANIMALS: Thirty-three client-owned dogs with naturally occurring CKD, including 26 with comorbidities...
March 2017: Journal of Veterinary Internal Medicine
https://www.readbyqxmd.com/read/28242135/hypoxia-inducible-factor-prolyl-hydroxylase-inhibitors-a%C3%A2-potential-new-treatment-for-anemia-in-patients-with-ckd
#11
REVIEW
Nupur Gupta, Jay B Wish
Erythropoiesis-stimulating agents (ESAs) increase hemoglobin levels, reduce transfusion requirements, and have been the standard of treatment for anemia in patients with chronic kidney disease (CKD) since 1989. Many safety concerns have emerged regarding the use of ESAs, including an increased occurrence of cardiovascular events and vascular access thrombosis. Hypoxia-inducible factor (HIF) prolyl hydroxylase (PH) enzyme inhibitors are a new class of agents for the treatment of anemia in CKD. These agents work by stabilizing the HIF complex and stimulating endogenous erythropoietin production even in patients with end-stage kidney disease...
February 24, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28186645/occult-gastrointestinal-bleeding-is-a-common-finding-in-dogs-with-chronic-kidney-disease
#12
Leandro Z Crivellenti, Sofia Borin-Crivellenti, Kristi L Fertal, Catarina M Contin, Caroline M J Miranda, Aureo E Santana
BACKGROUND: The risk of occult gastrointestinal bleeding (OGIB) is known to be increased among human dialysis patients suffering from end-stage renal disease. However, there are no studies to date that investigate the incidence of OGIB in either dogs or people with chronic kidney disease (CKD), irrespective of dialysis. OBJECTIVES: The purpose of the study was to determine whether the incidence of OGIB is greater in dogs with CKD as compared to a control population, and if this pathology is associated with changes in serum variables related to iron metabolism...
February 10, 2017: Veterinary Clinical Pathology
https://www.readbyqxmd.com/read/28182038/study-of-anemia-in-nondialysis-dependent-chronic-kidney-disease-with-special-reference-to-serum-hepcidin
#13
H Goyal, S Mohanty, M Sharma, A Rani
We studied the role of serum hepcidin in anemia of chronic kidney disease (CKD) in a hospital-based cross-sectional study. Serum hepcidin, ferritin, and high-sensitivity C-reactive protein (hsCRP) levels were evaluated in patients of CKD. Hepcidin levels were increased in patients as compared to healthy adults. Hepcidin levels increased as CKD progressed through stage 3-5 (P trend = 0.015) but did not correlate with estimated glomerular filtration rate. Hepcidin correlated positively with ferritin (P < 0...
January 2017: Indian Journal of Nephrology
https://www.readbyqxmd.com/read/28177098/-erythrocyte-abnormalities-and-their-possible-role-in-cardiovascular-complications-of-uremia
#14
Mario Bonomini, Arduino Arduini, Vittorio Sirolli, Natalia Di Pietro, Assunta Pandolfi
Cardiovascular (CV) disease is the leading cause of morbidity and mortality in patients with chronic kidney disease (CKD). Increased incidence of CV events in CKD is related to the presence, besides traditional CV risk factors, of non-traditional CV risk factors associated to renal insufficiency, like anemia. The role of red blood cells (RBC) in uremia has been taken into account almost exclusively in relation to their reduced number. However, RBC in the uremic milieu can acquire several abnormalities which may jeopardize their properties...
January 2017: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
https://www.readbyqxmd.com/read/28153964/anemia-in-peritoneal-dialysis-patients-iron-repletion-current-and-future-therapies
#15
REVIEW
Ahmed Zeidan, Sunil Bhandari
Iron deficiency, both functional and absolute, is common in patients with chronic kidney disease (CKD), especially those requiring dialysis. Guidelines advocate treatment of iron-deficiency anemia in patients with CKD and those on peritoneal dialysis (PD). Oral iron is often insufficient and slow to improve hemoglobin concentrations because of high hepcidin levels causing impaired absorption and mobilization, while intravenous (IV) supplementation replenishes and maintains iron stores more effectively and is now standard practice (Kidney Disease Improving Global Outcomes [KDIGO] 2012 guidelines)...
January 2017: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
https://www.readbyqxmd.com/read/28143866/mean-corpuscular-volume-and-mortality-in-patients-with-ckd
#16
Yao-Peng Hsieh, Chia-Chu Chang, Chew-Teng Kor, Yu Yang, Yao-Ko Wen, Ping-Fang Chiu
BACKGROUND AND OBJECTIVES: Mean corpuscular volume is the measure of the average size of the circulatory erythrocyte, and it is principally used as an index for the differential diagnosis of anemia. Recently, mean corpuscular volume has been associated with mortality in many clinical settings. However, the association of mean corpuscular volume with mortality in patients with CKD has not been fully addressed. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We conducted a retrospective observational cohort study of 1439 patients with stages 3-5 CKD and baseline mean corpuscular volume values from 2004 to 2012 in a medical center...
February 7, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28140480/acute-phase-proteins-and-iron-status-in-cats-with-chronic-kidney-disease
#17
R Javard, C Grimes, L Bau-Gaudreault, M Dunn
BACKGROUND: The role of inflammation in the development and progression of chronic kidney disease (CKD) in cats is not well characterized. Hepcidin is a recently discovered acute-phase protein (APP) that plays an important role in iron metabolism and contributes to the development of anemia in humans with CKD. OBJECTIVES: To compare serum APP concentrations, iron status, and erythropoietin (EPO) concentrations in healthy cats and cats with naturally occurring CKD...
March 2017: Journal of Veterinary Internal Medicine
https://www.readbyqxmd.com/read/28137221/methoxy-polyethylene-glycol-epoetin-beta-as-a-novel-erythropoiesis-stimulating-agent-with-possible-nephroprotective-and-cardiovascular-protective-effects-in-non-dialysis-chronic-kidney-disease-patients
#18
Bartnicki Piotr, Stępień Mariusz, Rysz Jacek
Chronic kidney disease (CKD) is an important health problem, because of unsuccessful outcomes such as CKD progression to end stage renal disease and high risk of cardiovascular disease (CVD). Anemia, associated with CKD, is considered a non-traditional risk factor for CVD which may contribute to faster CKD progression. Anemia treatment with erythropoiesis-stimulating agents (ESAs) seems to exert non-hematopoietic effects on different tissues and organs, including cardiovascular system and kidneys. On the other hand, clinical use of high doses of short-acting ESAs and higher target hemoglobin level were associated with higher risk of CVD...
January 26, 2017: Current Pharmaceutical Biotechnology
https://www.readbyqxmd.com/read/28135334/relative-incidence-of-acute-adverse-events-with-ferumoxytol-compared-to-other-intravenous-iron-compounds-a-matched-cohort-study
#19
James B Wetmore, Eric D Weinhandl, Jincheng Zhou, David T Gilbertson
Concerns persist about adverse reactions to intravenous (IV) iron. We aimed to determine the relative safety of ferumoxytol compared to other IV iron compounds. This retrospective cohort study with propensity-score matching for patients and drug doses used the Medicare 20% random sample to identify patients (1) without chronic kidney disease (non-CKD) and (2) with non-dialysis-dependent chronic kidney disease (NDD-CKD) who received a first dose of IV iron in 2010-2012. Exposures were ferumoxytol, iron sucrose, sodium ferric gluconate, or iron dextran...
2017: PloS One
https://www.readbyqxmd.com/read/28133420/high-levels-of-hemoglobin-promote-carotid-adventitial-vasa-vasorum-neoangiogenesis-in-chronic-kidney-disease
#20
Maria Vittoria Arcidiacono, Montserrat Martinez-Alonso, Montserrat Belart, Ana Vilar, Marisa Martín, Lourdes Craver, Àngels Betriu, Dídac Mauricio, José Manuel Valdivielso, Elvira Fernández, Mercè Borràs
Chronic kidney disease (CKD) patients, characterized by traditional and nontraditional risk factors, are prone to develop atheromatosis and thus cardiovascular events and mortality. The angiogenesis of the adventitial vasa vasorum (aVV) surrounding the carotid has been described as the atheromatosis initiator. Therefore, the aim of the study was to (1) evaluate if the carotid aVV in CKD patients increases in comparison to its physiological value of healthy patients; (2) explore which traditional or nontraditional risk factor including inflammation, bone and mineral metabolism, and anemia could be related to the aVV angiogenesis...
2017: Mediators of Inflammation
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